22. THE HEART AND CIRCULATION ;PROFESSIONAL ENGLISH IN USE FOR MEDICINE

PROFESSIONAL ENGLISH IN USE FOR MEDICINE

22. THE HEART AND CIRCULATION

A	Shortness of breath Shortness of breath, or breathlessness, is dyspnoea. At first this is caused by exertion – physical activity such as climbing stairs – but in severe cases it may present even at rest. A patient who is breathless when lying flat (orthopnoea), for example in bed, will tend to sleep raised up on two or more pillows. The abbreviation SOBOE stands for shortness of breath on exercise (or on exertion, or on effort). Patients say: I get terribly short of breath climbing stairs. Doctors can ask: How many pillows do you sleep of?
B	Heart rhythm The normal resting heart rate is 65-75 beats per minute. In athletes it may be as low as 40 beats per minute. In extreme athletic activity, the heart rate can go as high as 200/min. the heart rhythm may be regular or irregular. In an irregular rhythm (arrhythmia), there may be early beats which interrupt the regular rhythm (premature beats); or the rhythm may vary with respiration; or it may be completely irregular, as in fibrillation. When patients are aware of irregularity, they describe the symptom as palpitations. Case 4 A 22-year-old student was admitted to hospital with a long history of heart problems. She had been increasingly tires, with shortness of breath on exertion, orthopnoea, and palpitations. A mitral valve replacement had been carried out 3 years previously and this had stabilized the symptoms of heart failure but was followed by episodes (attacks) of atrial fibrillation, which had been particularly severe for the 6 months before admission.
C	Heart failure Heart failure occurs when the heart is unable to maintain sufficient cardiac output – the amount of blood pumped by the heart each minute – for the body’s needs. It may involve the left side of the heart, the right side, or both. In left heart failure the main symptom is breathlessness. The symptom of right heart failure include peripheral oedema (swelling), beginning in the feet and ankles. This is known as pitting oedema if, when a finger is pushed into the swelling, it causes a small depression or pit.

22.1	Complete the conversation based on the case history in B opposite. Doctor: What seems to be the problem? Patient: I’ve been getting (1) ___________. Doctor: How long have you had them? Patient: For about six months. But I’ve had heart problems for years, with tiredness and (2) ___________ of (3) ___________. In the end I couldn’t walk more than a hundred metres without having to stop. I had to sleep on three (4) ___________. I had a (5) ___________ replacement three years ago, and that improved things for a while.
22.2	Make word combinations using a word from each box. Two words can be used twice. Look at B and C opposite to help you. at atrial cardiac heart on pitting premature output failure oedema fibrillation beats effort rest
22.3	Write the words a patient would use to describe the symptoms below. Look at A, B, and C opposite to help you 1 dyspnoea 2 arrhythmia 3 orthopnoea 4 oedema
22.4	Complete the case report. Look at A, B and C opposite to help you Case 13 A 60-year-old woman attended her GP’s surgery complaining of breathlessness on (1) ___________. This had been increasing over the previous eight months until it was producing problems at around 500 metres walking on the level. There was no history of chest pain. She had several (2) ___________ of fast (3) ___________ which lasted 20-30 minutes and were associated with some (4) ___________ of breath. She had noticed some (5) ___________ of her ankles by the end of the day. This disappeared overnight.

ANSWER KEY